3885 Main St Bridgeport Dental Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

3885 MAIN ST BRIDGEPORT DENTAL INC

Doing business as

Connecticut Family Dental

Practice address

3885 Main St Ste 101
Bridgeport, CT 06606-2814

Phone

(203) 663-2772

NPI assigned

Apr 23, 2021

Last updated

Apr 23, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Longqian Wang, DDSNPI 1669086575

Title

General Dentist

Phone

(929) 285-8883

Specialties & licenses 1

Addresses

Other names 1

• Connecticut Family Dental Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Longqian Wang

  • Dentist
  • Derby, CT
  • NPI 1669086575
  NPD Authorized official
• Deokjun Choi

  • Dentist
  • Bridgeport, CT
  • NPI 1306416250
  NPD
• Oliver Sun

  • General Practice Dentistry
  • Lyndhurst, OH
  • NPI 1407239379
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1831771450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 POST RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 MAIN ST STE 101",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062814",
            "telephone_number": "203-663-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3885 MAIN ST BRIDGEPORT DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "LONGQIAN",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "929-285-8883",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 4A Friend Healthcare Corp
• A Mother Level Doula Service
• A Plus Dental Care
• A Winning Smile LLC
• A&P Sisterly United

• General Practice Dentistry in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.